Is this normal? common pregnancy symptoms by trimester

By Dr. Samantha Berg, Board Certified OB/GYN

First plus sign? Congrats, mama! Though I've cared for thousands of women and deliver sweet babies almost on a daily basis, I'm forever in awe of what our bodies are capable of in bringing new life into the world. But just because it's incredible doesn't mean it doesn't get pretty uncomfortable hosting a tiny human in your uterus for 9 months. Your body is undergoing so many physical changes, redirecting resources, and even shifting organs to make a nice home for them to thrive.

Pregnancy symptoms can pop up right from the beginning, and change throughout the course of your pregnancy due to fluctuating hormones and your growing baby. Some pretty unexpected ones too (think bleeding gums, congestion, and wider feet). Though every woman's body is different, it's good to be aware of the most common pregnancy symptoms to help put your mind at ease or know when you should call the doctor.

Fatigue

This is definitely the most common symptom of early pregnancy. Sometimes it can be the hardest, especially if you have other little ones running around. This usually improves in the second trimester. I recommend early bedtime and naps when you can. Also, if you are having insomnia, Unisom or Benadryl are safe to use during pregnancy and can aid in longer stretches of sleep.

Nausea/Vomiting

Not everyone will experience nausea or vomiting and when patients do, there is a spectrum. Some women are nauseous all day but do not throw up. Some throw up once per day, but feel okay the rest of the day. There is also a serious condition called Hyperemesis Gravidarum that can persist longer than the first trimester and affect nutrition. To help patients get relief, I usually recommend small frequent meals/snacks as opposed to larger ones, ginger chews, staying hydrated, and plain crackers. If that's not enough, I would talk to your doctor about taking medication. There are a lot of safe options available.

cramping

Mild or dull cramping (think period cramps) is very common in the first trimester. This happens as the uterus stretches and grows. However, severe pain is not normal. Contact your doctor immediately if you experience this.

Round ligament pain

The uterus is attached to the pelvis by ligaments. As the uterus grows these ligaments can get pulled on, resulting in pain near the groin. It can feel sharp or like a cramp and last seconds to minutes. It usually resolves itself quickly and is not rhythmic (coming and going in regular intervals). It can happen more when turning over in bed, getting up from sitting, or walking. Pregnancy belts can help if round ligament pain is happening frequently when you're moving.

Fetal movement

Most patients will first feel fetal movement between 18-22 weeks. Some women may feel it sooner if it is not their first pregnancy. At first, it can feel like bubbles (think gas). It does not feel like kicks until later in the pregnancy when babe's legs get bigger and stronger. Most providers do not recommend counting movements (fetal kick counts) until 28 weeks.

Braxton-hicks

You might start to feel the muscles in your uterus tighten for 30 seconds to a minute or two starting in the second trimester. These "warm up" contractions are totally normal and do not signal that labor is coming. While Braxton Hicks go away on their own, real labor does not. Other differences? The real thing is much more painful and follows a regular pattern (labor contractions get stronger, longer, and closer together). Make sure you know the signs of real labor and call your doctor if you're concerned.

insomnia

This is a very common symptom in the third trimester (and sometimes throughout pregnancy, unfortunately). Often it is because it is uncomfortable to sleep or you have to get up to urinate multiple times at night. Sometimes you just wake up and are not quite sure why. I recommend not drinking a ton of fluid right before bed to hopefully decrease the amount of late-night bathroom trips. Make sure you have a cool room to sleep in with comfortable pillows. Also, minimizing screen time prior to sleep does help. Benadryl or Unisom are safe to take and can be helpful to get a few more hours of sleep.

Back pain

Lower back pain is very common during pregnancy, especially in the third trimester. It makes sense that there is strain on the lower back from your growing uterus, but it can get so uncomfortable for some women that it impacts their day-to-day. Staying active and stretching can help. Also, Tylenol is safe to take during pregnancy and can get you some relief. I also recommend applying a heating pad on low setting or using a pregnancy support belt to help alleviate some of the strain.

heartburn

Pregnancy hormones help ligaments relax to make room for your baby. Unfortunately, this also applies to the muscles in your lower esophagus. This combined with upward pressure of your growning uterus can lead to uncomfortable heartburn, even for those who've never experienced it before. What makes it worse? Spicy, greasy, fatty foods, or eating large meals in one sitting. I recommend grazing throughout the day, avoiding troublesome foods, and not laying down right after meals. You can also talk to your doctor about antacids that are safe to take during pregnancy.

Wherever you are in your journey, I hope that you are feeling well, nourishing your body, and resting as much as you can. Every pregnancy is different, and some are more of a struggle than others, but there's no reason to suffer. Talk to your doctor about the options available to get relief, and don't be shy about contacting us day or night if something feels off. You know your body best and we're here to help ensure you and baby stay safe and healthy.

Have a question for Dr. Berg? Check our her pregnacy/labor/postpartum FAQs or DM us on Instagram!

Meet the expert
SAMANTHA BERG, MD

Dr. Berg is a board certified OB/GYN who completed her medical degree at Keck School of Medicine of the University of Southern California. She then completed her internship and residency at the University of Southern California/LAC+USC Medical Center. Dr. Berg’s private practice specializes in comprehensive healthcare for women, including obstetrics and general gynecology. She practices in San Diego where she currently resides with her husband and one-year-old son.